Assessment of intrapelvic cement and screws in revision total hip arthroplasty

Vascular injury resulting from primary and revision hip arthroplasty has been reported to involve both arterial and venous structures. While such complications are extremely uncommon, removal of intrapelvic cement or screws during revision surgery can be hazardous to intrapelvic structures. Both arterial and venous perforations can occur, depending on the level at which the pelvic wall has been breached, and on the orientation of the intruding matter. Complications can be minimized with careful preoperative assessment of pelvic anatomy. Contrast-enhanced computerized tomography scanning can assist the revision surgeon with preoperative planning in those patients requiring removal of intrapelvic components. This technique appears to be an accurate, simple, and noninvasive method by which these intrapelvic relationships may be examined.